Methods and conduits for flowing blood from a heart chamber to a blood vessel

ABSTRACT

Disclosed is a conduit that provides a bypass around an occlusion or stenosis in a coronary artery. The conduit is a tube adapted to be positioned in the heart wall to provide a passage for blood to flow between a heart chamber and a coronary artery, at a site distal to the occlusion or stenosis. The conduit has a section of blood vessel attached to its interior lumen which preferably includes at least one naturally occurring one-way valve positioned therein. The valve prevents the backflow of blood from the coronary artery into the heart chamber.

CROSS-REFERENCE TO RELATED APPLICATION

This application is a continuation of U.S. application Ser. No.09/828,794, filed Apr. 10, 2001, now U.S. Pat. No. 6,881,199 which is acontinuation of U.S. application Ser. No. 09/369,061, filed Aug. 4,1999, now U.S. Pat. No. 6,254,564, which claims the benefit of U.S.Provisional application Ser. No. 60/099,719, filed Sep. 10, 1998, theentire disclosures of each being incorporated by reference herein.

FIELD OF THE INVENTION

This invention relates to apparatus and method for implanting a conduitto allow communication of fluids from one portion of a patient's body toanother; and, more particularly, to a blood flow conduit to allowcommunication from a heart chamber to a vessel or vice versa, and/orvessel to vessel. Even more particularly, the invention relates to aleft ventricular conduit and related conduit configurations having ablood vessel graft incorporated therein for controlling the flow ofblood through the conduit to achieve bypass of an occluded or stenosedcoronary artery.

BACKGROUND OF THE INVENTION

Coronary artery disease is a major problem in the U.S. and throughoutthe world. Coronary arteries as well as other blood vessels frequentlybecome clogged with plaque which, at the very least, can reduce bloodand oxygen flow to the heart muscle (myocardium), and may impair theefficiency of the heart's pumping action, and can lead to heart attack(myocardial infarction) and death. In some cases, these coronaryarteries can be unblocked through noninvasive techniques such as balloonangioplasty. In more difficult cases, a surgical bypass of the blockedvessel is necessary.

In a coronary bypass operation, one or more venous segments are insertedbetween the aorta and the coronary artery, or, alternatively, the distalend of an internal mammary artery is anastomosed to the coronary arteryat a site distal to the stenosis or occlusion. The inserted venoussegments or transplants act as a bypass of the blocked portion of thecoronary artery and thus provide for a free or unobstructed flow ofblood to the heart. More than 500,000 bypass procedures are performed inthe U.S. every year.

Such coronary artery bypass graft (CABG) surgery, however, is a veryintrusive procedure which is expensive, time-consuming, and traumatic tothe patient. The operation requires an incision through the patient'ssternum (sternotomy), and that the patient be placed on a heart-lungbypass pump so that the heart can be operated on while not beating. Asaphenous vein graft is harvested from the patient's leg, another highlyinvasive procedure, and a delicate surgical procedure is required topiece the bypass graft to the coronary artery (anastomosis). Hospitalstays subsequent to the surgery and convalescence are prolonged.Furthermore, many patients are poor surgical candidates due to otherconcomitant illnesses.

As mentioned above, another conventional treatment is percutaneoustransluminal coronary angioplasty (PTCA) or other types of angioplasty.However, such vascular treatments are not always indicated due to thetype or location of the blockage or stenosis, or due to the risk ofemboli.

Thus, there is a need for an improved coronary bypass system which isless traumatic to the patient.

SUMMARY OF THE INVENTION

The present invention addresses the need in the previous technology byproviding a coronary bypass system which avoids a sternotomy and otherintrusive aspects associated with coronary bypass surgery. It also freesthe surgeon from having to perform multiple anastomoses, as is necessaryin the current process.

The present device provides a conduit for diverting blood directly froma heart chamber, such as the left ventricle of the heart, to thecoronary artery distal to the blockage or stenosis, thereby bypassingthe blocked portion of the vessel. The conduit comprises a tube adaptedto be positioned in the heart wall and having a section of blood vesselattached to the interior of the conduit, to provide a passage for bloodflow which is similar to the body's own blood vessels.

The conduit device is delivered through the coronary artery to aposition distal the blockage or stenosis. At that position, the coronaryartery and the wall of the left ventricle, including the myocardium, arepierced to provide an opening or channel completely through from thecoronary artery to the left ventricle of the heart. The conduit is thenpositioned in the opening to provide a permanent passage for blood toflow between the left ventricle of the heart and the coronary artery,distal to the blockage or stenosis.

The conduit is sized so that one open end is positioned within thecoronary artery, while the other open end is positioned in the leftventricle. Prior to implantation of the conduit, a section of vein orother blood vessel is obtained from the patient, from another humandonor, or from a nonhuman animal. The vein or other blood vessel issized so as to fit within the interior of the conduit. The hollow lumenof the conduit with the blood vessel graft inserted therein provides apassage for the flow of blood.

If desired, the section of blood vessel inserted into the conduit mayinclude one or more naturally occurring one-way valves. The valveprevents the backflow of blood from the myocardium into the leftventricle. For example, a section of vein having a valve therein can beused. Alternatively, the pulmonic valve or aortic valve obtained from anonhuman animal, such as a fetal pig or piglet, can be used to provide aone-way passage for the flow of blood through the conduit.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1A is a schematic, cross-sectional view of a human heart, showing aconduit in the myocardium of the heart for forming a bypass between theleft ventricle and a coronary artery;

FIG. 1B is an enlarged view of the bypass conduit of FIG. 1A;

FIG. 2 is an exploded view of a vein graft incorporated into a heartconduit in accordance with the preferred arrangement;

FIG. 3 is a close-up, cross-sectional view of a blockage or stenosis inthe coronary artery, illustrating the conduit of the preferredarrangement positioned so as to bypass the blockage or stenosis.

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENT

As is well known, the coronary artery branches off the aorta and ispositioned along the external surface of the heart wall. Oxygenatedblood that has returned from the lungs to the heart then flows from theheart to the aorta. Some blood in the aorta flows into the coronaryarteries, and the remainder of blood in the aorta flows on to the restof the body. The coronary arteries are the primary blood supply to theheart muscle and are thus critical to life. In some individuals,atherosclerotic plaque, aggregated platelets, and/or thrombi build upwithin the coronary artery, blocking the free flow of blood and causingcomplications ranging from mild angina to heart attack and death. Thepresence of coronary vasospasm, also known as “variant angina” or“Prinzmetal's angina,” compounds this problem in many patients.

As used herein, the term “heart chamber” primarily refers to theinterior, or lumenal, aspect of the left or right ventricle or the leftor right atrium. The term “conduit,” “stent,” and “tube” herein refer tophysical structures, preferably primarily artificial, that can bepositioned between two or more chambers or vessels, to allow blood flowfrom one chamber or vessel to another. A “shunt” is any natural orartificial passage between natural channels, such as heart chambers orblood vessels. The conduit in the preferred arrangement can be made of avariety of materials, including various metals, such as nitinol, orplastics.

As used herein, the term “heart wall” comprises any one or more of thefollowing portions or layers of the mammalian heart: the epicardium,myocardium, endocardium, pericardium, interatrial septum, andinterventricular septum.

The principles of the present invention are not limited to leftventricular conduits, and include conduits for communicating bodilyfluids from any space within a patient to another space within apatient, including any mammal. Furthermore, such fluid communicationthrough the conduits is not limited to any particular direction of flowand can be antegrade or retrograde with respect to the normal flow offluid. Moreover, the conduits may communicate between a bodily space anda vessel or from one vessel to another vessel (such as an artery to avein or vice versa). Moreover, the conduits can reside in a singlebodily space so as to communicate fluids from one portion of the spaceto another. For example, the conduits can be used to achieve a bypasswithin a single vessel, such as communicating blood from a proximalportion of an occluded coronary artery to a more distal portion of thatsame coronary artery.

In addition, the conduits and related methods can preferably traversevarious intermediate destinations and are not limited to any particularflow sequence. For example, in one preferred embodiment of the presentinvention, the conduit communicates from the left ventricle, through themyocardium, into the pericardial space, and then into the coronaryartery. However, other preferred embodiments are disclosed, includingdirect transmyocardial communication from a left ventricle, through themyocardium and into the coronary artery. Thus, as emphasized above, theterm “transmyocardial” should not be narrowly construed in connectionwith the preferred fluid communication conduits, and other nonmyocardialand even noncardiac fluid communication are preferred as well. Withrespect to the walls of the heart (and more specifically the term “heartwall”), the preferred conduits and related methods are capable of fluidcommunication through all such walls including, without limitation, thepericardium, epicardium, myocardium, endocardium, septum, etc.

The bypass which is achieved with certain preferred embodiments andrelated methods is not limited to a complete bypass of bodily fluidflow, but can also include a partial bypass which advantageouslysupplements the normal bodily blood flow. Moreover, the obstructionsthat are bypassed may be of a partial or complete nature, and thereforethe terminology “bypass” or “occlusion” should not be construed to belimited to a complete bypass or a complete occlusion but can includepartial bypass and partial occlusion as described.

The preferred conduits and related methods disclosed herein can alsoprovide complete passages or partial passages through bodily tissues. Inthis regard, the conduits can comprise stents, shunts, or the like, andtherefore provide a passageway or opening for bodily fluid such asblood. Moreover, the conduits are not necessarily stented or lined witha device but can comprise mere tunnels or openings formed in the tissuesof the patient.

The conduits of the present invention preferably comprise both integralor one-piece conduits as well as plural sections joined together to forma continuous conduit. The present conduits can be deployed in a varietyof methods consistent with sound medical practice including vascular orsurgical deliveries, including minimally invasive techniques. Forexample, various preferred embodiments of delivery rods and associatedmethods are disclosed. In one embodiment, the delivery rod is solid andtrocar-like. It may be rigid or semi-rigid and capable of penetratingthe tissues of the patient and thereby form the conduit, in whole or inpart, for purposes of fluid communication. In other preferredembodiments, the delivery rods may be hollow so as to form the conduitsthemselves (e.g., the conduits are preferably self-implanting orself-inserting) or have a conduit mounted thereon (e.g., the deliveryrod is preferably withdrawn leaving the conduit installed). Thus, thepreferred conduit device and method for installation is preferablydetermined by appropriate patient indications in accordance with soundmedical practices.

In order to restore the flow of oxygenated blood through the coronaryartery, the preferred arrangement provides for the shunting of blooddirectly from the heart to a site in the coronary artery which is distalthe blockage or stenosis.

Although the specification herein will describe the conduit primarilywith reference to the left ventricle, the preferred arrangement can beused with any of the four heart chambers, and with any coronary artery,including the left main coronary artery, the right coronary artery, theleft anterior descending artery, the left circumflex artery, theposterior descending artery, the obtuse marginal branch or a diagonalbranch.

A tunnel or opening is formed through the wall of the coronary arteryand the myocardium and into the left ventricle of the heart which liesbeneath, or deep to, the coronary artery. A conduit is positioned in theopening to keep it open.

The conduit may be introduced into the myocardium in a variety of ways,including by a catheter threaded through the femoral artery into theaorta and thence into the left ventricle and, if necessary, the leftatrium; or by a catheter threaded through the femoral vein into theinferior vena cava and thence into the right atrium and right ventricle.Alternatively, the conduit may be introduced through a surgical incisionin chest wall (thoracotomy) or sternum (sternotomy).

Further details regarding conduits and conduit delivery systems aredescribed in copending patent applications entitled, DESIGNS FOR LEFTVENTRICULAR CONDUIT, U.S. application Ser. No. 09/369,048, filed Aug. 4,1999, VALVE DESIGNS FOR LEFT VENTRICULAR CONDUIT, U.S. application No.Ser. No. 09/368,393, filed Aug. 4, 1999, LEFT VENTRICULAR CONDUITS TOCORONARY ARTERIES AND METHODS FOR CORONARY BYPASS, U.S. application Ser.No. 09/534,038, filed Mar. 24, 2000, and BLOOD FLOW CONDUIT DELIVERYSYSTEM AND METHOD OF USE, U.S. application Ser. No. 09/368,644, filedAug. 4, 1999, and U.S. Pat. Nos. 6,261,304, 5,429,144 and 5,662,124, thedisclosures of which are all hereby incorporated by reference in theirentirety.

The opening through the heart wall (including endocardium, myocardium,and epicardium) and coronary artery can be formed in a variety of ways,including by knife or scalpel, electrocautery, cryoablation,radiofrequency ablation, ultrasonic ablation, and the like. Othermethods will be apparent to those of ordinary skill in the art.

The conduit is provided with a section of vein or other blood vesselpositioned within its interior lumen. The section of vein or other bloodvessel is obtained from the patient, from a donor, or from an animal.Prior to implantation of the conduit, a segment of blood vessel sized tofit with the lumen of the conduit is inserted into the conduit. Theconduit with the graft therein provides a passage for the flow of bloodwhich is similar to the natural human blood vessels. The segment of veinor other blood vessel harvested to fit within the conduit may includeone or more of the valves which naturally occur in the human body. Thesevalves act to prevent the backflow of blood. In the conduit, thesenaturally occurring venous valves prevent the blood from flowing backinto the left ventricle of the heart from the coronary artery. Thesegment of vein is preferably inserted into the conduit prior to theconduit's deployment into the human body by any of various surgical orcatheter-guided techniques known to those of skill in the art.

Referring now to FIGS. 1A and 1B, a coronary artery bypass isaccomplished by disposing a conduit 12 (FIG. 1B) in a heart wall ormyocardium MYO of a patient's heart PH (FIG. 1A). The conduit 12preferably extends from the left ventricle LV of heart PH to a cloggedcoronary artery CA at a point downstream of a blockage BL to create apassageway 8 therethrough. Conduit 12 is preferably made of abiocompatible material such as stainless steel or nitinol, althoughother materials such as Ti, Ti alloys, Ni alloys, Co alloys andbiocompatible polymers may also be used. In one embodiment, conduit 12has a one way valve 6 to allow blood to flow from the left ventricle LVto the coronary artery CA. Although the conduit 12 may elasticallydeform under the contractive pressure of the heart muscle duringsystole, the stent remains open to allow blood to pass from thepatient's left ventricle LV into the coronary artery CA. Duringdiastole, the blood pumped into coronary artery through passageway 8 isblocked by one-way valve 6 from returning to left ventricle LV.

As shown in FIG. 2, a preferred embodiment involves the use of a veingraft 10 taken from the patient. Prior to preparing the conduit 12 forplacement in the patient, a section of vein 10 is obtained from thepatient (i.e., an autologous graft or autograft). Of course, a bloodvessel taken from another human donor (i.e., an allogeneic graft orallograft) or nonhuman animal species (i.e., a heterologous graft orxenograft) could also be used. The vein 10 is preferably taken from thesaphenous vein in the leg of the patient. Alternatively, a donor veincould be used, or a fetal pig or piglet can be obtained and dissected toremove a section of the pulmonary artery having a pulmonic valvetherein, or a section of the aorta having an aortic valve therein, or asimilar vessel having a naturally occurring valve system. In otherembodiments, the endothelial lining of a vein and/or a valve may begrown from one or more tissue cultures, utilizing cloning of donor celllines or other genetic engineering techniques (or “tissue engineering”)known to those of skill in the art. Thus, as used herein, “a section ofblood vessel” may include one or more of the following: a surgicallyresected segment of a blood vessel, with or without one or more valves;the endothelial lining of a blood vessel, taken from an in vitro or invivo specimen; and one or more venous valves, taken from in vitro or invivo specimens.

As noted above, the section of vein 10 or other blood vessel harvestedpreferably contains one or more valves 14, which occur naturally in theveins. The section of vein 10 may also not have a valve. The veinsection 10 is sized so as to be the same length as the conduit 12. Thevein section 10 is placed within the interior lumen of the conduit 12and attached to the inside of the conduit 12 by suturing or otherattachment methods. The natural vein graft 10 is biocompatible andtherefore reduces problems associated with rejection of the conduit 12and clotting around or in the conduit 12. In addition, the vein 10provides a natural valve system 14 that is already used throughout thehuman body to prevent the backflow of blood. In the case of a xenograft,treatment of the graft with chemicals, such as glutaraldehyde, may beundertaken to remove living cells, including antigenic materials, fromthe connective tissue framework of the graft so as to reducethrombogenicity and antigenicity.

Referring now to FIG. 3, a self-expanding conduit 12 having a section ofvein 10 therein is introduced into the wall of the myocardium MYO asfollows. A conduit delivery catheter (not shown), having the compressedconduit 12 mounted on its distal end, is advanced over a puncturemechanism and into the wall of the myocardium MYO at a site distal tothe blockage or stenosis BL in the coronary artery CA. When the conduit12 is property seated in the myocardial wall MYO, its retaining sheathis withdrawn, allowing the conduit 12 to expand and open a passageway,or maintain patency of the passageway, from the left ventricle of theheart LV to the coronary artery CA. This allows oxygenated blood to flowdirectly from the left ventricle of the heart LV through the conduit 12and to the coronary artery CA, bypassing the section of coronary arteryCA that is blocked BL, as shown by the arrows in FIG. 3.

The conduit 12 may include attachment mechanisms not limited to hooks,barbs, large collars, and/or other methods to ensure that a seal iscreated between the coronary artery CA and the wall of the heart wallMYO, to prevent hemorrhaging and to prevent the threat of or actualconduit migration. When positioning and securing of the conduit 12 iscompleted, the remaining catheter assembly is removed, leaving theconduit 12 with the vein graft therein, in place in the body

The present vascular conduit having a blood vessel graft incorporatedtherein provides significant improvements in the present treatment ofblockages or stenoses in the coronary artery. Although the invention hasbeen described in its preferred embodiments in connection with theparticular figures, it is not intended that this description should belimited in any way by the foregoing.

1. A conduit for implantation in the heart, the conduit comprising: anexpandable, vascularly deliverable, hollow, metal tube having aninterior and an exterior and configured to be positioned between a bloodvessel and a heart chamber; a first end open towards and positionedwithin the blood vessel and a second end open towards the heart chamber,wherein the first and second ends are continuously open uponimplantation of the conduit in a body, the tube includes a substantiallylattice structure adjacent each of the first and second ends andextending therebetween, and a substantially straight line intersects atleast a portion of the first end and at least a portion of the secondend; and a section of body tissue attached to the tube within saidinterior of the tube and adapted to allow blood to flow therethrough,wherein the section of body tissue contains at least one tissue valveoperable to restrict flow through the conduit from the blood vessel tothe heart chamber during diastole, wherein the valve is positionedbetween the first and second ends.
 2. The conduit of claim 1, whereinthe section of body tissue is a section of a blood vessel.
 3. Theconduit of claim 2, wherein the section of blood vessel is one of anautograft, an allograft, and a xenograft.
 4. The conduit of claim 1,wherein said heart chamber is a left ventricle.
 5. The conduit of claim1, wherein the tube is self-expandable.
 6. The conduit of claim 1,wherein the conduit includes an attachment mechanism adapted to connectto heart and/or vessel tissue.
 7. The conduit of claim 1, wherein theconduit is configured to be delivered in a compressed configuration. 8.The conduit of claim 1, wherein the conduit is configured to bedelivered via a catheter.
 9. The conduit of claim 1, wherein the bloodvessel is a coronary vessel.
 10. The conduit of claim 9, wherein thecoronary vessel is a coronary artery.
 11. The conduit of claim 1,wherein the first end is a distalmost end and the second end is aproximalmost end.
 12. The conduit of claim 11, wherein each of thedistalmost and the proximalmost ends is expandable.
 13. The conduit ofclaim 1, wherein the tube and the section of body tissue aresubstantially the same length.
 14. A method of flowing blood from aheart chamber to a blood vessel, the method comprising: inserting withina body a metal conduit with a first end and a second end, wherein eachof the first and second ends is continuously open upon implantation ofthe conduit in the body, and at least a portion of the first end facesat least a portion of the second end; wherein a section of tissue isattached to the conduit within the interior of the conduit adjacent thefirst end, the section of tissue including a tissue valve attached tothe conduit within an interior of the conduit, and positioned betweenthe first and second ends; placing the conduit within a heart wall suchthat the first end of the conduit is open towards the heart chamber, thesecond end is open towards the blood vessel, and the second end ispositioned within the blood vessel; and during diastole, restricting aflow of blood from the blood vessel to the heart chamber via the tissuevalve.
 15. The method of claim 14, wherein the section of tissueincludes a section of blood vessel containing at least one naturallyoccurring valve.
 16. The method of claim 15, wherein the section ofblood vessel is one of an autograft, an allograft, and a xenograft. 17.The method of claim 14, wherein the heart chamber is a left ventricle.18. The method of claim 14, wherein the first end is a distalmost end ofthe conduit and the second end is a proximalmost end of the conduit. 19.The method of claim 18, wherein each of the distalmost and theproximalmost ends is expandable.
 20. The method of claim 14, wherein theconduit includes a longitudinal axis and the first and second endsintersect the longitudinal axis.
 21. The method of claim 14, whereinplacing the conduit includes deploying the conduit via a solid deliveryrod.
 22. A heart implant comprising: an expandable, vascularlydeliverable, hollow, metal conduit having an interior and an exteriorand configured to be positioned between a blood vessel and a heartchamber; a first end open towards and positioned within the blood vesseland a second end open towards the heart chamber, wherein each of thefirst and second ends is continuously open upon implantation of theconduit in a body, at least a portion of the first open end faces atleast a portion of the second open end, and the conduit includes asubstantially lattice structure adjacent each of the first and secondends and extending therebetween; and a valve of animal tissue attachedto the conduit within said interior of the conduit and positionedbetween the first and second ends and adapted to allow blood to flowtherethrough, wherein the valve of animal tissue is operable to restrictflow through the conduit from the blood vessel to the heart chamberduring diastole.
 23. The implant of claim 22, wherein the animal tissueis obtained from a nonhuman animal.
 24. The implant of claim 23, whereinthe nonhuman animal is a pig.
 25. The implant of claim 22, wherein thevalve of animal tissue is a section of a blood vessel.
 26. The implantof claim 25, wherein the section of the blood vessel is one of anautograft, an allograft, and a xenograft.
 27. The implant of claim 22,wherein said heart chamber is a left ventricle.
 28. The implant of claim22, wherein the conduit is self-expandable.
 29. The implant of claim 22,wherein the implant includes an attachment mechanism adapted to connectto heart and/or vessel tissue.
 30. The implant of claim 29, wherein theattachment mechanism includes one of a barb, a hook, and a collar. 31.The implant of claim 22, wherein the conduit is configured to bedelivered in a compressed configuration.
 32. The implant of claim 22,wherein the conduit is configured to be delivered via a catheter. 33.The implant of claim 22, wherein the blood vessel is a coronary vessel.34. The implant of claim 22, wherein the conduit is a stent.
 35. Theheart implant of claim 22, wherein the first end is a distalmost end andthe second end is a proximalmost end.
 36. The heart implant of claim 35,wherein each of the distalmost and the proximalmost ends is expandable.37. The heart implant of claim 22, wherein the conduit includes alongitudinal axis, the first end intersects the longitudinal axis, andthe second end intersects the longitudinal axis.
 38. The implant ofclaim 22, wherein the valve of animal tissue is formed from tissueengineering techniques.
 39. A method of flowing blood from a heartchamber to a blood vessel, the method comprising: inserting into a bodya metal conduit with a first end and a second end, wherein each of thefirst and second ends is continuously open upon implantation of theconduit in the body, a substantially straight line intersects at least aportion of the first end and at least a portion of the second end, andthe conduit includes a substantially lattice structure adjacent each ofthe first and second ends and extending therebetween; wherein a valve ofanimal tissue is attached to the conduit within an interior of theconduit and positioned between the first and second ends; placing theconduit within a heart such that the first end of the conduit is opentowards the heart chamber, and the second end is open towards the bloodvessel and positioned within the blood vessel; and during diastole,restricting a flow of blood from the blood vessel to the heart chambervia the valve of animal tissue.
 40. The method of claim 39, wherein theanimal tissue is obtained from a nonhuman animal.
 41. The method ofclaim 40, wherein the nonhuman animal is a pig.
 42. The method of claim39, wherein the valve includes a section of blood vessel containing atleast one naturally occurring valve.
 43. The method of claim 42, whereinthe section of blood vessel is one of an autograft, an allograft, and axenograft.
 44. The method of claim 39, wherein the heart chamber is aleft ventricle.
 45. The method of claim 39, wherein the blood vessel isa coronary vessel.
 46. The method of claim 39, further comprisingdelivering the conduit to the heart by a catheter threaded through anartery into the aorta.
 47. The method of claim 39, wherein placing theconduit includes expanding the conduit.
 48. The method of claim 39,wherein the first end is a distalmost end of the conduit and the secondend is a proximalmost end of the conduit.
 49. The method of claim 48,wherein each of the distalmost and the proximalmost ends is expandable.50. The method of claim 39, wherein the conduit includes a longitudinalaxis and the first and second ends intersect the longitudinal axis. 51.The method of claim 39, wherein placing the conduit includes deployingthe conduit via a solid delivery rod.
 52. The method of claim 39,wherein the animal tissue is obtained from tissue engineeringtechniques.
 53. A conduit for implantation in the heart, the conduitcomprising: an expandable, vascularly deliverable, hollow, metal tubehaving an interior and an exterior and configured to be positionedbetween a blood vessel and a heart chamber; a first end open towards andpositioned within the blood vessel and a second end open towards theheart chamber, wherein the first and second ends are continuously openupon implantation of the conduit in a body, and wherein a substantiallystraight line intersects at least a portion of the first end and atleast a portion of the second end; and a section of body tissue attachedto the conduit adjacent the second end and within said interior of thetube and adapted to allow blood to flow therethrough, wherein thesection of body tissue contains a valve of animal tissue operable torestrict flow through the conduit from the blood vessel to the heartchamber during diastole, wherein the valve is positioned between thefirst and second ends.
 54. The conduit of claim 53, wherein the sectionof body tissue is a section of a blood vessel.
 55. The conduit of claim54, wherein the section of blood vessel is one of an autograft, anallograft, and a xenograft.
 56. The conduit of claim 53, wherein theconduit is self-expandable.
 57. The conduit of claim 53, wherein theconduit includes an attachment mechanism adapted to connect to heartand/or vessel tissue.
 58. The conduit of claim 53, wherein the conduitis configured to be delivered in a compressed configuration.
 59. Theconduit of claim 53, wherein the conduit is configured to be deliveredvia a catheter.
 60. The conduit of claim 53, wherein the tube includesat least one of a hook, a barb, and a collar to inhibit migration of theconduit.
 61. The conduit of claim 53, wherein the valve is operable topermit flow through the conduit from the heart chamber to the bloodvessel during systole.
 62. The conduit of claim 53, wherein the valve ofanimal tissue is an aortic valve.
 63. The conduit of claim 53, whereinthe valve is chemically treated by a chemical treating agent.
 64. Theconduit of claim 63, wherein the chemical treating agent isglutaraldehyde.
 65. The conduit of claim 53, wherein the tube is anitinol stent.
 66. The conduit of claim 53, wherein the body tissue isobtained from a nonhuman animal.
 67. A method of flowing blood from aheart chamber to a blood vessel, the method comprising: inserting into abody a conduit with a first end and a second end, wherein each of thefirst and second ends is continuously open upon implantation of theconduit in the body, and a substantially straight line intersects atleast a portion of the first end and at least a portion of the secondend, the conduit further including a substantially lattice structureadjacent the first end and adjacent the second end and extendingtherebetween; wherein a valve of animal tissue is attached to theconduit within an interior of the conduit and positioned between thefirst and second ends; placing the conduit between the heart chamber andthe blood vessel such that the first end of the conduit is open towardsthe heart chamber, the second end is open towards the blood vessel, andthe second end is positioned within the blood vessel; and duringdiastole, restricting a flow of blood from the blood vessel to the heartchamber via the valve of animal tissue.
 68. The method of claim 67,wherein the animal tissue is obtained from a nonhuman animal.
 69. Themethod of claim 68, wherein the nonhuman animal is a pig.
 70. The methodof claim 67, wherein the valve includes a section of blood vesselcontaining at least one naturally occurring valve.
 71. The method ofclaim 70, wherein the section of blood vessel is one of an autograft, anallograft, and a xenograft.
 72. The method of claim 67, wherein theheart chamber is a left ventricle.
 73. The method of claim 67, whereinthe blood vessel is a coronary vessel.
 74. The method of claim 67,further comprising delivering the conduit to the heart by a catheterthreaded through an artery into the aorta.
 75. The method of claim 67,wherein placing the conduit includes expanding the conduit.
 76. Themethod of claim 67, wherein the first end is a distalmost end of theconduit and the second end is a proximalmost end of the conduit.
 77. Themethod of claim 76, wherein each of the distalmost and the proximalmostends is expandable.
 78. The method of claim 67, wherein the conduitincludes a longitudinal axis and the first and second ends intersect thelongitudinal axis.
 79. The method of claim 67, wherein the conduitincludes at least one of a hook, a barb, and a collar to inhibitmigration of the conduit.
 80. The method of claim 67, wherein the valveof animal tissue includes an aortic valve.
 81. The method of claim 67,wherein the valve of animal tissue includes a non-venous valve.
 82. Themethod of claim 67, wherein the valve of animal tissue is formed fromtissue engineering techniques.
 83. The method of claim 67, whereinplacing the conduit includes delivery the conduit via a solid deliveryrod.